If a disability prohibits you from working, Social Security Disability Insurance or Supplemental Security Income can help you survive financially until you get back on your feet.
Unfortunately, many people with legitimate disabilities struggle to get their disability benefits approved by the Social Security Administration (SSA). The SSA regularly denies original disability claims as well as appeals. A West Palm Beach Social Security Disability lawyer at the Law Offices of Anidjar & Levine understands how to navigate this complex and frustrating process to give you the best possible chance of getting your benefits approved.
Call the West Palm Beach personal injury lawyers at the Law Offices of Anidjar & Levine for a free consultation.
How to Qualify for Social Security Disability
The process for disability qualification can vary depending on the type of benefits for which you qualify: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Social Security Disability Insurance (SSDI)
Each week that you work, you pay into and accumulate eligibility credits for SSDI. Once you accumulate the necessary credits to qualify, you can apply for SSDI as a worker, divorced or widowed spouse, or an adult child.
Qualification involves the Social Security Administration (SSA) evaluating your disability, a process that will look at:
- Your current work activity
- The severity of your disability
- How your disability meets their guidelines
- Your ability to work in your previous job
- Your current ability to work in a new job
There are some exceptions to these qualifications, such as for blindness or other vision problems. Our attorneys can go over how to prove that you meet these requirements.
Supplemental Security Income (SSI)
If you have not contributed sufficiently or accumulated the necessary credits for SSDI, you may qualify for SSI. You can attempt to qualify for SSI if you have a disability (as defined by the SSA) or if you are age 65 or older.
While SSDI is based on your work, SSI is based on your income and resources. Your application may consider your:
- Wages or salary
- Social Security benefits
- Pensions
- Spouse’s or parents’ income
- Stocks and bonds
- Real estate
When applying for SSI benefits, it’s important to know what income will be considered in your case. If you have questions about eligibility or your application was denied because of an income issue, the team at the Law Offices of Anidjar & Levine can go over your case with you.
Disability Guidelines of SSA
If you have a condition or impairment (mental or physical) that prevents you from working, you may have a valid claim for disability. However, the SSA requires that your impairment be provable based on their standards. The impairment must either be life-threatening or has kept (or will keep) you out of work for at least 12 months.
If your injury occurred at work, you may be able to seek workers’ compensation benefits instead of disability or supplemental income benefits. The details of your case and coverage could determine your eligibility, so check with our workers’ compensation lawyers to learn more.
The SSA publishes a list of established, acceptable impairments, such as:
- Spinal stenosis
- Cancer
- Congenital heart disease
- Schizophrenia
- Cystic fibrosis
- HIV
- Inflammatory arthritis
This is a fraction of the listed conditions that could qualify you for benefits. Disability benefits cover neurological, cardiovascular, musculoskeletal, respiratory, and even skin conditions. The SSA’s Listing of Impairments contains more detailed information about acceptable health conditions.
If the publication lists your condition, application and approval can be easier. If it does not list your condition, that’s okay. The SSA can still approve your claim as long as you present the required proof.
Documenting a Social Security Disability Claim
If you qualify to receive SSDI or SSI, you can submit your claim to the SSA. However, your claim must adhere to the SSA standards for format and content. In fact, an incomplete or incorrect claim submission is the reason most applicants receive a denial of disability benefits from the SSA.
Having a West Palm Beach Social Security Disability lawyer who understands how to construct an acceptable claim submission — like our attorneys — will help you achieve the best possible outcome in your case. We can help identify and avoid any minor errors that could warrant a denial. You shouldn’t have to keep waiting to receive benefits!
Building Your Claim
A medical evaluation — known as the Residual Functional Capacity (RFC) assessment — will form the foundation of your claim. This will evaluate your:
- Physical abilities
- Mental abilities
- Other affected abilities
- Limiting effect on your life
The goal of this assessment is to provide a more nuanced look at your condition. Rather than just evaluating one aspect of your condition, it should provide a clearer picture of how your disability has impacted your overall work capability and quality of life.
However, your RFC may be only the starting point for your claim. Depending on the nature of your disability, a complete claim may require a wealth of additional supporting documentation. It is your responsibility as an applicant to present that documentation, but our SSDI/SSI attorneys can help so that you aren’t overwhelmed.
Common Reasons for Denial
Knowing the typical pitfalls of this process can help you avoid them. Some of the factors that can affect your disability claim approval include:
- Inexperienced doctors: If the doctor you see for your RFC assessment lacks specific experience in preparing this document or conducting assessments for Social Security Disability claim, they may not provide you with what you need for approval. This will lead to the denial of your claim.
- Unqualified doctor: The SSA imposes specific standards of qualification for the doctor or medical professional performing the RFC. If your doctor lacks those qualifications, the SSA can use this as a basis to deny your claim.
- Incorrect claim format: To obtain SSA approval, you must submit your claim in accordance with their formatting requirements. Failure to comply will lead to a denial of your claim.
- Submitting incomplete medical records: The medical records required by the SSA depend on the nature of your impairment. However, if you fail to submit everything they require, they will deny your claim.
- Submitting extraneous medical records: If you submit more records or information than the SSA requires, it can also lead to a denial of your claim. If the SSA can cite other conditions or factors that could contribute to your inability to work, they may use this as grounds to deny your claim.
As you can see, rather than ask you to correct or provide more information, the SSA generally just denies claims that have these errors or gaps. While this is intimidating, it also means you’re not alone. Moreover, given that denials are common, the system provides alternate options to still pursue benefits.
Understanding Social Security Disability Benefits
Social Security Disability (SSD) benefits provide financial assistance to individuals who are unable to work due to a disabling medical condition. In West Palm Beach, qualifying for SSD benefits requires meeting specific criteria set by the Social Security Administration (SSA). Applicants must have a medically determinable physical or mental impairment that has lasted or is expected to last at least 12 months or result in death. The condition must be severe enough to prevent you from performing not only your previous work but also any other substantial gainful activity available in the national economy. Understanding these requirements is crucial for a successful application, as even minor errors or omissions can lead to a denial of benefits.
Common Reasons for Denial of SSD Claims
Many initial SSD applications are denied due to avoidable mistakes or insufficient evidence. Common reasons for denial include:
- Insufficient Medical Evidence: Failure to provide comprehensive medical records that substantiate the severity and duration of your disability.
- Incomplete Application Forms: Omissions or errors in the application can lead to automatic denial.
- Failure to Follow Prescribed Treatment: Not adhering to your doctor’s treatment plan may cause the SSA to question the legitimacy of your claim.
- Earning Above Substantial Gainful Activity (SGA) Limits: Earning more than the allowed amount can disqualify you from receiving benefits.
- Lack of Cooperation with the SSA: Not responding to requests for additional information or failing to attend required examinations.
Understanding these common pitfalls can help you prepare a more effective application and increase your chances of approval.
How a Social Security Disability Lawyer Can Assist You
Engaging a Social Security Disability lawyer can significantly enhance your chances of a successful claim. An experienced attorney will guide you through the complex application process, ensuring all forms are accurately completed and submitted on time. They can help gather and organize essential medical evidence, communicate with healthcare providers, and obtain expert opinions to strengthen your case. If your initial application is denied, your lawyer can represent you during the appeals process, which may include hearings before an administrative law judge. Their expertise not only increases the likelihood of a favorable outcome but also alleviates the stress of navigating the system alone, allowing you to focus on your health and well-being.
A Social Security Disability Lawyer Understands the System
Understanding and providing what the SSA needs to approve your claim requires an extensive background and knowledge of the system. Here at the Law Offices of Anidjar & Levine, our legal team routinely assists clients in getting their disability benefits approved — even after the SSA denies your claim.
Our team will assemble the appropriate records for your claim and ensure you see a doctor who is qualified by SSA standards and knowledgeable about conducting and reporting the RFC examination.
In addition to the RFC report, we may include other medical documentation such as:
- Doctor treatment reports
- Surgery reports
- Lab test reports
- Imaging test reports
- Treatment history
- Medication history
- Therapy reports
- Treatment plans
Once we submit your claim, the SSA may contact you to request additional documentation. They may also demand that you report for a compulsory medical exam or CME, sometimes called a consultative examination (CE). This exam could be done by your own doctor or by an independent consultant chosen by the SSA.
Because the SSA sometimes uses this as a reason to deny your claim, contact our office immediately before you respond to or report for a CME.
Appealing a Denied Social Security Disability Claim
Our legal team will help you achieve the best possible outcome in your case. However, the SSA initially denies a large portion of Social Security Disability claims. Don’t panic if this happened to you. If you received a denial, we can help.
That said, you only have 60 days to file your Request for Reconsideration (RfR). Consequently, you must contact us as soon as possible upon receiving your denial. We will prepare your RfR based on the cited reason for the denial and include any additional documentation requested.
Requesting An Administrative Hearing
If you receive a denial of your RfR, we can request an administrative hearing, where a judge can grant approval of SSA Disability claims. If the judge denies your claim at the hearing, we can appeal his or her decision to an entity known as the Appeals Council.
If the Appeals Council fails to overturn the administrative law judge’s ruling, we have one final option, which involves appealing to the Federal Court. At the Law Offices of Anidjar & Levine, we are willing to go that far for you to receive recognition and benefits for your condition.
Nonetheless, it may not come to that. After all, as you can see, we have multiple options for getting your SSA Disability claim approved, even after a denial. Don’t give up, just get help.
Free Case Review From a Social Security Disability Lawyer in West Palm Beach, FL
Applying — and getting approval for — Social Security disability (SSI or SSDI) requires extensive knowledge and a thorough understanding of how this exhausting process works. At the Law Firm of Anidjar & Levine, we will work tirelessly on your behalf to get you the disability benefits you need. Even if you already received a denial of your claim, our legal team can help.
To schedule a no-cost consultation with a Florida Social Security Disability lawyer, contact us today.
We Can Help.
